Evaluation of Methods for Dissemination of Prostate Cancer Survivorship Guidelines: A Survey of Primary Care Providers

Abstract

Objectives: To assess potential knowledge gaps between primary care providers (PCPs) and cancer specialists, Michigan Cancer Consortium guidelines were developed and disseminated statewide. We evaluated the impact of dissemination of these guidelines on PCP attitudes and beliefs regarding management of prostate cancer (PC) post-treatment sequelae. Methods: Guidelines were disseminated via hard-copy and web-link mailed to 12,000 Michigan PCPs in 2009, and via 5 CME presentations to 181 PCPs in 2010-2011. 132 initial surveys were collected from CME attendees and 549 follow-up surveys were received 20 months after the initial mailing. Results: Surveyed PCPs indicated erectile dysfunction (88%), incontinence (84%), anxiety (54%) and fear of the unknown (50%) as frequent post-treatment sequelae. A minority of PCPs (≤41%) felt “very comfortable” assessing PC patients for ten post-treatment sequelae at the initial survey, which increased by up to 27% on follow-up survey. 93% of PCPs that received guidelines by mail and CME presentation had incorporated them into practice, compared with 72% of PCPs that received guidelines solely by mailing. Similarly, a greater proportion reported practice pattern changes (65% vs. 34%, p = 0.0003). A higher proportion felt CME events (69% vs. 57%) and expert presentations (64% vs. 44%) were “very effective”, when comparing attendees and non-attendees. Conclusions: Guideline distribution resulted in increased comfort with survivorship issues and incorporation into the practices of the majority of PCPs surveyed. A greater impact was observed in PCPs that attended a CME presentation than in those that received guidelines only by mailing.

Share and Cite:

S. Mendonca, M. Berenji, C. Tobert, H. Stetler, D. Bisel and B. Lane, "Evaluation of Methods for Dissemination of Prostate Cancer Survivorship Guidelines: A Survey of Primary Care Providers," Open Journal of Urology, Vol. 3 No. 3, 2013, pp. 165-172. doi: 10.4236/oju.2013.33031.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] American Cancer Society, “Prostate Cancer Overview,” 2012. http://www.cancer.org/acs/ groups/cid/documents/webcontent/ 003134-pdf.pdf
[2] B. D. Smith, G. L. Smith, A. Hurria, et al., “Future of Cancer Incidence in the United States: Burdens upon an Aging, Changing Nation,” Journal of Clinical Oncology, Vol. 27, No. 17, 2009, pp. 2758-2765. doi:10.1200/JCO.2008.20.8983
[3] S. L. Bober, C. J. Recklitis, E. G. Campbell, et al., “Caring for Cancer Survivors: A Survey of Primary Care Physicians,” Cancer, Vol. 115, No. S18, 2009, pp. 4409-4418. doi:10.1002/cncr.24590
[4] M. Hewitt, S. Greenfield and E. Stovall, “From Cancer Patient to Cancer Survivor: Lost in Transition. Committee on Cancer Survivorship: Improving Care and Quality of Life, National Cancer Policy Board. Institute of Medicine and National Research Council of the National Academies,” National Academy Press, Washington DC, 2005.
[5] C. F. Snyder, K. D. Frick, R. J. Herbert, et al., “Preventive Care in Prostate Cancer Patients: Following Diagnosis and for Five-Year Survivors,” Journal of Cancer Survivorship, Vol. 5, No. 3, 2011, pp. 283-291. doi:10.1007/s11764-011-0181-y
[6] P. A. Ganz, “Survivorship: Adult Cancer Survivors,” Primary Care, Vol. 36, No. 4, 2009, pp. 721-741. doi:10.1016/j.pop.2009.08.001
[7] T. A. Skolarus, M. Holmes-Rovner, L. L. Northouse, et al., “Primary Care Perspectives on Prostate Cancer Survivorship: Implications for Improving Quality of Care,” Urologic Oncology: Seminars and Original Investigations, 2011.
[8] C. Erikson, E. Salsberg, G. Forte, et al., “Future Supply and Demand for Oncologists: Challenges to Assuring Access to Oncology Services,” Journal of Oncology Practice, Vol. 3, No. 2, 2007, pp. 79-86. doi:10.1200/JOP.0723601
[9] Michigan Cancer Consortium Prostate Cancer Action Committee, “Guidelines for Primary Care Management of Prostate Cancer Post-Treatment Sequelae,” 2012. http://www.michigancancer.org/ PDFs/MCCGuidelines-Primary CareMgtProstateCaPost-TxSequelae.pdf
[10] Michigan Cancer Consortium, “Fact Sheet about Symptoms after Prostate Cancer Treatment,” 2012. http://www.prostatecancerdecision.org/MCCfactsheets.htm
[11] B. T. Allaire, J. G. Trogdon, B. M. Egan, et al., “Measuring the Impact of a Continuing Medical Education Program on Patient Blood Pressure,” The Journal of Clinical Hypertension, Vol. 13, No. 7, 2011, pp. 517-522. doi:10.1111/j.1751-7176.2011.00469.x
[12] D. J. Brimmer, K. K. McCleary, T. A. Lupton, et al., “A Train-the-Trainer Education and Promotion Program: Chronic Fatigue Syndrome—A Diagnostic and Management Challenge,” BMC Medical Education, Vol. 8, 2008, pp. 49-58. doi:10.1186/1472-6920-8-49
[13] A. Treiyer, P. Anheuser, Z. Bütow, et al., “A Single Center Prospective Study: Prediction of Postoperative General Quality of Life, Potency and Continence after Radical Retropubic Prostatectomy,” Journal of Urology, Vol. 185, No. 5, 2011, pp. 1681-1685. doi:10.1016/j.juro.2010.12.052
[14] M. E. Del Giudice, E. Grunfeld, B. J. Harvey, et al., “Primary Care Physicians’ Views of Routine Follow-Up Care of Cancer Survivors,” Journal of Clinical Oncology, Vol. 27, No. 20, 2009, pp. 3325-3338. doi:10.1200/JCO.2008.20.4883
[15] D. A. Asch, M. K. Jedrziewski and N. A. Christakis, “Response Rates to Mail Surveys Published in Medical Journals,” Journal of Clinical Epidemiology, Vol. 50, No. 10, 1997, pp. 1129-1136. doi:10.1016/S0895-4356(97)00126-1

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.